DR. Michael Thomas Tom, D.D.S.

NPI #1477558138 in Fort Wayne, Indiana

Provider Information

NPI Number
1477558138
Entity Type
Individual
Name
DR. Michael Thomas Tom, D.D.S.
Gender
Not Specified
Sole Proprietor
Not Answered
Primary Specialty
Dentist
Credential
D.D.S.
Enumeration Date
Jun 17, 2005
Last Updated
Jul 8, 2007

Practice Location

Address
1220 MEDICAL PARK DR
Address 2
STE 1
State
Indiana
ZIP Code
46825-5843
Phone
(260) 482-9196

Specialties & Taxonomy Codes

Specialty
Dentist

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